The award-winning journalist delivers a deeply researched account of the controversy surrounding the Gender Identity Development Service based at the Tavistock and Portman Trust in North London.
Shortlisted for The Orwell Prize for Political Writing 2023
Shortlisted for the Baillie Gifford Prize for Non-Fiction 2023
Time to Think goes behind the headlines to reveal the truth about the NHS's flagship gender service for children.
The Gender Identity Development Service (GIDS), based at the Tavistock and Portman Trust in North London, was set up initially to provide - for the most part - talking therapies to young people who were questioning their gender identity. But in the last decade GIDS has referred more than a thousand children, some as young as nine years old, for medication to block their puberty. In the same period, the number of young people seeking GIDS's help exploded, increasing twenty-five-fold. The profile of the patients changed too: from largely pre-pubescent boys to mostly adolescent girls, who were often contending with other difficulties.
Why had the patients changed so dramatically? Were all these distressed young people best served by taking puberty blockers and then cross-sex hormones, which cause irreversible changes to the body? While some young people appeared to thrive after taking the blocker, many seemed to become worse. Was there enough clinical evidence to justify such profound medical interventions in the lives of young people who had so much else to contend with?
This urgent, scrupulous and dramatic book explains how, in the words of some former staff, GIDS has been the site of a serious medical scandal, in which ideological concerns took priority over clinical practice. Award-winning journalist Hannah Barnes has had unprecedented access to thousands of pages of documents, including internal emails and unpublished reports, and well over a hundred hours of personal testimony from GIDS clinicians, former service users and senior Tavistock figures. The result is a disturbing and gripping parable for our times.
Publisher: Swift Press
ISBN: 9781800751132
Number of pages: 464
Dimensions: 198 x 129 mm
‘An exemplary and detailed analysis of a place whose doctors, Barnes writes, most commonly describe it as “mad”... Powerful’ - Financial Times
‘A deeply reported, scrupulously non-judgmental account of the collapse of the NHS service, based on hundreds of hours of interviews with former clinicians and patients. It is also a jaw-dropping insight into failure: failure of leadership, of child safeguarding and of the NHS’ - Sunday Times
‘This book is a testament to the moral courage of Hutchinson and colleagues who sought to expose the chaos and insanity they saw while practising by stealth the in-depth therapy they believed young people deserved … And Hannah Barnes has honoured them with her dogged, irreproachable yet gripping account’ - The Times
'This incredibly important book shows that we still don’t know how many children were damaged for life. I want every institution and every politician who pontificates about gender to read this book and ask what happened to all those lost girls and boys – and why they were complicit’ - Daily Telegraph
‘At times, the world Barnes describes feels like some dystopian novel. But it isn’t, of course. It really happened, and she has worked bravely and unstintingly to expose it. This is what journalism is for’ - Observer
‘The question Barnes puts at the centre of this book is “Are we hurting children?" What follows is an extraordinarily sensitive and important piece of work that exposes the huge price some of our young have had to pay for a system that was simply not rigorous enough in asking that question. Time to Think – which explores the rapid rise and phenomenal growth of the GIDS clinic at the Tavistock – is essential reading for anyone who wants to understand how safeguarding concerns got lost, despite the best intentions of practically all those involved. 'The testimonies in the book are raw, honest and moving. More than that they are a vital piece of evidence that shows – without prejudice – where things went right, where things went wrong and, remarkably, the thousands of cases of young people where we still don’t know' Emily Maitlis
'Time to Think shows what happens when the exponents of an ideology, so certain of its righteousness, capture a field of medicine, silencing critics, refusing even to collect follow-up data on whether its treatments actually work' - The Times Best Books of 2023 So Far
‘A powerful investigation … The interviews with staff and children — some who have happily transitioned and some who have not — show how complex the issues are. Not a comfortable read but meticulous and thought-provoking’ - Camilla Cavendish, Financial Times, Best Summer Books of 2023
'Meticulous and scrupulously researched book on Gids’ downfall' - Lucy Mangan, Guardian
'Truly illluminating ... a work of diligent, intellectually fearless reportage into the Tavistock Centre’s child gender identity development service' - Sunday Times, Best Books of Summer
'A brilliant book written in a very thoughtful way about the failures of the Tavistock clinic' - Wes Streeting
I've been following the story of what has been going on at the Tavistock GIDS since first hearing about Board member David Bell's concerns. There are many shocking revelations in this detailed and... More
A searing account of how the leadership at GIDS including Polly Carmichael utterly failed many of the children who walked in their doors, with many issues they simply ignored, even though they were brought up... More
This book is excellent & heartbreaking. Hannah Barnes has done a thorough forensic investigation into the scandal of children basically being experimented on. The Tavistock did not make adequate records, or do... More
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